后路解锁内固定后经胸前路椎体切除减压钛网植骨融合治疗上胸椎骨折脱位合并截瘫

Unlock the Joint Followed Internal Fixation Posterior Approach and Resecting Thoracic Vertebral Body with Titanium Mesh Bone Fusion via Thoracic Approach for the Treatment of the Fracture and Dislocation of Upper Thoracic Spine combined Paraplegia

目的：探讨胸椎骨折的特点及治疗。方法：11例病人，男性7例，女性4例，AO分型A型2例、B型6例、C型3例，完全瘫的6例，不完全瘫的5例，单侧小关节绞锁5例，双例小关节绞锁6例。均经后路切开解锁复位内固定、然后经胸前路椎体切除钛网植骨融合治疗。结果：随访18个月～24个月，后路长节段固定随访时无一例失败。完全瘫的患者6例有1例神经功能改善I级，不完全瘫的5例均有Ⅲ级改善。结论：上胸椎骨折损伤严重，后路切开解锁复位内固定术后经胸前路椎体切除减压钛拢植骨融合治疗是一种合理的有效治疗方法。

Objective： To analyze the characteristics and treatment of fractures of upper thoracic vertebrae. Methods： Among 11 patients（male 7, female 4）, 2 in A , 6 in B and 3 in C according to AO classification, 6 complete paralysis and 5 incomplete paralysis, 5 locked joint for one--side and 6 locked joint for two--side. All unlock the joint and internal fixation posterior approach and resecting thoracic vertebral body with titanium mesh bone fusion via thoracic approach for the treatment. Results： All these patients were followed up from 18 months to 24 months. None of the long--term internal fixation was unsatisfied, moreover,of 7 cases with complete paralysis neurological function improved from A to B. 5 caes incomplete paralysis neurological function were improved from C to E. Conclusion： Fractures of the upper thoracic vertebrae are severe injuries of spine and spinal cord, unlock the joint followed internal fixation posterior approach and resecting thoracic vertebral body with titanium mesh bone fusion via thoracic approach wight be an effective treatment for it.